March 25 2015, Wednesday
IMA NEWS
Government Stands up and takes a note of IMA Contribution in control of TB
Government Stands up and takes a note of IMA Contribution in control of TB
editorial
Stress is the reaction of the body and mind to the interpretation of a known situation
Dr KK Aggarwal You cannot be stressed unless you know the person, place or the situation. The same situation may or may not cause stress unless it is interpreted in such a way that it is uncomfortable to the person, and then it ends up causing stress.
Management of stress, therefore, involves either removing the known situation or changing one’s interpretation or preparing the body in such a way that the stress does not affect mind and the body. But, removing the known situation may not be possible all the time. For example, if you are stressful in a job, resigning may not be feasible.

The modality, therefore, is to change your interpretation towards the stressful situation for which one should start thinking positively and different and choose the resultant options within, which do not hurt the heart.

Changing of the interpretation is what in allopathy is described as cognitive behavior therapy, the origin of which comes from Ayurveda and in Bhagwad Gita where Lord Krishna counsels Arjuna following principles of Cognitive Behavioral Therapy.

In the first chapter, Lord Krishna only listens to Arjuna explaining the importance of listening, listening and listening. The second counseling session or the second chapter is the longest conversation between Arjuna and Krishna and shows the importance of first effective counseling session. In Chapters 3 to 17, Krishna explains what he has conveyed in chapter 2 and that tells us the importance of reasoning out every doubt that a person under stress has. During this session, Krishna creates both fear as well as consoles Arjuna again indicating the importance of these two factors in counseling. In the last chapter, Krishna revises what he has taught, which is consistent with the last rule of counseling to make sure that the patient has learnt what has been taught to him.

Apart from counseling, one can also prepare the body in such a way that stress does not bother him. This can be done by learning the art of pranayam, relaxation, meditation, regular exercise, Dosh-specific diet and using certain Ayurvedic Rasayans, which sterilize the brain functions. Brahmi, an Ayurvedic herb, is one such Rasayan, which boosts the brain.

One should avoid taking allopathic anti–anxiety drugs, unless necessary which, of course, may be required in an acute panic state.
eMedipics IMA,IJCP,HCFI
Dr AJ Premkumar Satya President IMA Poonamallee High Road branch sub: World TB Day Observance
News
  • A short daytime nap could significantly boost brain power, suggests a new study from Saarland University in Germany. The study is published in the journal Neurobiology of Learning and Memory. Researchers noted that a sleep of around 45–60 minutes could improve learning and memory by fivefold.
  • A study published in the March issue of Arthritis Care & Research has shown that distraction seems to be the greatest risk factor for new-onset acute low back pain (LBP). Study authors noted that onset was most likely between 7:00 am and noon, that the risk was substantially increased by a number of modifiable physical and psychosocial triggers, and that people >60 years of age were less at risk from heavy loads than younger participants.
  • New research presented at the 249th National Meeting & Exposition of the American Chemical Society suggests that taking vitamin D supplements may slow or reverse the progression of low–grade prostate tumors, without the need for surgery or radiation therapy.
  • Intravenous (IV) cosyntropin therapy in the treatment of postdural puncture headache shows efficacy that is similar to that of, but is slower to take effect than, the current gold standard treatment, an epidural blood patch, suggests a new study presented at the American Academy of Pain Medicine (AAPM) 31st Annual Meeting.
  • Exposure to the sun during adulthood might cause more nonmelanoma skin cancer than exposure during childhood, suggests a new study presented at the American Academy of Dermatology 73rd Annual Meeting.
Dr KK Spiritual Blog
On 5th Navratri learn detached attachment and to control one's ego

Skanda Mata is worshipped on the fifth Day of Navratri. SHE is holding her son ‘Skandaa or Kartikeya’ on her lap.

SHE has three eyes and four hands. Two hands hold lotuses while the other two hands respectively display defending and granting gestures.

She is the ocean of knowledge. She rides on a lion.

In Yoga Shastra she represents the Vishuddha chakra and HAM bija mantra. She also dignifies motherhood, fertility and mother child relationship.

Skandaa means the one with six heads corresponding to the five senses and the mind. Or the one who has a control over the six demonic vices: kama (sex), krodha (anger), lobha (greed), moha (passion), mada (ego) and matsarya (jealousy).

Kartikeya carries on one hand a spear and his other hand is always blessing devotees. His vehicle is a peacock, a pious bird that grips with its feet a serpent, which symbolizes the ego and desires of people. The peacock represents the destroyer of harmful habits and the conqueror of sensual desires.

Spiritual mantra on the 5th Navratri

One should learn detached attachment as the main principle of spirituality.
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Cardiology eMedinewS
  • The risk of future atrial fibrillation (AF) decreases with increasing cardiorespiratory fitness (CRF)—up to a point, suggests a new analysis of a large cohort of middle-aged men. The benefit was seen within an optimal range of fitness, but the risk increased in the most highly trained men, those considered "the fittest of the fit." The findings are published online in Heart Rhythm.
  • Five years after patients with left main coronary stenosis either underwent PCI with a sirolimus–eluting stent or had CABG, there was no difference in major adverse cardiac or cerebrovascular events (MACCE) in the two groups, reported the Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients With Left Main Coronary Artery Disease (PRECOMBAT) trial. The findings were presented at the American College of Cardiology 2015 Scientific Sessions.
Pediatrics eMedinewS
  • A recent study published in the Journal of the American Academy of Child and Adolescent Psychiatry revealed that following military parents' return from combat deployment, their children show increased visits for mental healthcare, physical injury, and child maltreatment consults, compared to children whose parents have not been deployed.
  • Training parents to engage in treatment of their children with attention-deficit/hyperactivity disorder (ADHD) symptoms improves the collaborative care model and the outcomes in all three key measures tested — hyperactivity/impulsivity, social skills, and oppositionality — suggests new research published online March 23 in Pediatrics.
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Make Sure
Situation: A patient was brought to the ICU in cardiogenic shock.
Reaction: Oh my God! Why didn’t you take him for emergency angiography and subsequent PTCA?
Lesson: Make Sure to perform an emergency diagnostic angiography and mechanical revascularization with PTCA in patients of cardiogenic shock. Results of NRMI–2 trial suggest that this intervention is much better than thrombolytic therapy in such patients.
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Events
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Medicolegal
(Contributed by Dr Sudhir Gupta, Prof & Head, Forensic Medicine & Toxicology, AIIMS)

Sudden death due to cardiac origin–autopsy

Right coronary artery supplies blood to electrical area of heart
The most common cause of sudden cardiac death in adults over the age of 40 is coronary artery atheroma seen in postmortem examination in about 100 cases randomly selected by me in AIIMS Mortuary.
  • The most common finding at postmortem examination is chronic high–grade stenosis of minimum one segment of a major coronary artery, the arteries which supply the heart muscle with its blood supply.
  • A significant number of cases also have an identifiable clot in a major coronary artery which causes transmural occlusion of that vessel.
  • In 75 cases out of hundred, the clots were seen in right coronary artery supplying the electrical area of heart.
  • Death in these cases is thought to result from a period of transient or prolonged lack of blood supply in the muscle of the heart wall which induces a ventricular arrhythmia/fibrillation and no changes in the myocardium is seen during postmortem examination.
  • The absence of the histological signs of acute necrosis and a healed infarct are a common finding.
  • Chronic high–grade stenosis causing previous episodes of ischemia and areas of focal fibrosis is seen histologically in the myocardium.
  • Ventricular arrhythmias may arise from a myocardium, which has been previously scarred by episodes of ischemia.
Dr Good Dr Bad
Situation:A patient with skin disease needed circumcision and wanted to know whether Mediclaim covers it or not. 
Dr. Bad: It will not be covered. 
Dr. Good: It will be covered.
Lesson: Circumcision is excluded unless it is necessary for treatment of a disease.

(Copyright IJCP)
IJCP Book of Medical Records
IJCP’s ejournals
Wellness Blog
Gaining weight losing strength versus losing weight gaining strength

When we gain weight, we must acquire more strength and when we lose weight, we must lose the strength. This is a fundamental principle.

If we gain weight and feel weak, it is a disease and when we lose weight and gain strength, we are recovering from the disease. One should not gain more than 5kg of weight after the age of 20 years. Any weight gain after that will only be due to accumulation of fat, which leads to insulin resistance.

Insulin resistance does not allow food to convert into energy. In the state of insulin resistance, whatever you eat is converted into fat. As it is not converted into energy, you feel weak. When you reduce insulin resistance by drugs or walking, the metabolism becomes normal and whatever you eat gets converted into energy and you start gaining strength.
Quote of the Day
If the road is beautiful then, worry about the destination, but if the destination is beautiful, then don't worry about the road!
eMedi Quiz
The substances present in the gallbladder stones or the kidney stones can be best identified by the following technique:

1. Fluorescence spectroscopy.
2. Electron microscopy.
3. Nuclear magnetic resonance.
4. X-ray diffraction.


Yesterday’s Mind Teaser:The following separation technique depends on the molecular size of the protein:

1. Chromatography on a carboxymethyl (CM) cellulose column.
2. Iso–electric focusing.
3. Gelfiltration chromatography.
4. Chromatography on a diethylaminoethly (DEAE) cellulose column.

Answer for yesterday’s Mind Teaser: 3.Gelfiltration chromatography.

Correct Answers received from: Dr Jainendra Upadhyay, Dr Avtar Krishan, Daivadheenam Jella

Answer for 23rd March Mind Teaser: 1.Glyceraldehyde–3–phosphate Dehydrogenase

Correct Answers receives:Dr Jainendra Upadhyay, Dr Sharad SJ, Dr Shangarpawar, Dr Avtar Krishan, Daivadheenam Jella, Dr Poonam Chablani, Dr Prabodh K Gupta
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Reader Response
  1. Tomatoes and prostate cancer is not a new news. I have known about it for some years. I think the prostate cancer prevalence in Italy is lower because of higher tomato consumption. Regards: Vijay Anthwal.
Rabies News (Dr A K Gupta)
Can the wound be deepened for cleaning purpose?

We should never try to deepen the bite wound. Deepening of wound for cleaning depends on area of injury, extent of injury and the aim should be to preserve as much tissue as possible and to excise only the dead tissue.
CPR 10
Total CPR since 1st November 2012 – 101090 trained
Video of the Day
Sameer Malik Heart Care Foundation Fund
The Sameer Malik Heart Care Foundation Fund is a one of its kind initiative by the Heart Care Foundation of India instituted in memory of Sameer Malik to ensure that no person dies of a heart disease because they cannot afford treatment. Any person can apply for the financial and technical assistance provided by the fund by calling on its helpline number or by filling the online form.
Madan Singh,
SM Heart Care Foundation Fund, Post CAG
Kishan, SM Heart Care Foundation Fund, Post CHD Repair
Deepak, SM Heart Care Foundation Fund, CHD TOF
Section 66 A of IT Act unconstitutional: Implications to medical profession
What is 66A of IT Act 66A.
66A. Punishment for sending offensive messages through communication service, etc.

Any person who sends, by means of a computer resource or a communication device
(a) any information that is grossly offensive or has menacing character; or
(b) any information which he knows to be false, but for the purpose of causing annoyance, inconvenience, danger, obstruction, insult, injury, criminal intimidation, enmity, hatred or ill will, persistently by making use of such computer resource or a communication device,
(c) any electronic mail or electronic mail message for the purpose of causing annoyance or inconvenience or to deceive or to mislead the addressee or recipient about the origin of such messages, shall be punishable with imprisonment for a term which may extend to three years and with fine.

Explanation— For the purpose of this section, terms “electronic mail” and “electronic mail message” means a message or information created or transmitted or received on a computer, computer system, computer resource or communication device including attachments in text, images, audio, video and any other electronic record, which may be transmitted with the message. What are the implications to medical profession: Note: 66A stuck down but that does not make one immune from following MCI ethics regulations. Protected health information cannot be leaked.

MCI Code of Ethics Regulations Applicable
• MCI Oath Declaration: g: I will respect the secrets which are confined in me.
• 2.2 Patience, Delicacy and Secrecy : Patience and delicacy should characterize the physician. Confidences concerning individual or domestic life entrusted by patients to a physician and defects in the disposition or character of patients observed during medical attendance should never be revealed unless their revelation is required by the laws of the State. Sometimes, however, a physician must determine whether his duty to society requires him to employ knowledge, obtained through confidence as a physician, to protect a healthy person against a communicable disease to which he is about to be exposed. In such instance, the physician should act as he would wish another to act toward one of his own family in like circumstances.

• MCI 7.14 "The registered medical practitioner shall not disclose the secrets of a patient that have been learnt in the exercise of his / her profession except –

1. in a court of law under orders of the Presiding Judge;
2. in circumstances where there is a serious and identified risk to a specific person and / or community; and
3. notifiable diseases.
In case of communicable / notifiable diseases, concerned public health authorities should be informed immediately.

• MCI 7.17 " A registered medical practitioner shall not publish photographs or case reports of his / her patients without their permission, in any medical or other journal in a manner by which their identity could be made out. If the identity is not to be disclosed, the consent is not needed.
Sonal Namaste
How do you use hand sanitizers?
  • Apply the product to the palm of one hand (read the label to learn the correct amount).
  • Rub your hands together.
  • Rub the product over all surfaces of your hands and fingers until your hands are dry
Government of National Capital Territory of Delhi
(Health & Family Welfare Department)
9111 Level, A–Wing, Room No. 910, Delhi Sachivalaya,
I.P. Estate, New  Delhi (23392031),
osdpsh@gmail.com
No. F8(72)/Director(hosp.services)/HFW/2015/163-68   

Date: 16/ 03/15

CIRCULAR

It has been noticed that resident doctors are often assigned continuous duties across multiple shifts. In order  to improve the working environment and enhance productivity  and  outcomes,   it  has  been  decided   to  curb  this  practice  and  restrict clinical duties of resident doctors  to a single.

All Directors/Medical Superintendents and Heads of clinical departments of hospitals/institutions/departments are  advised   that  in  case, resident   doctors  are assigned continuous duties across multiple shifts in their hospitals institutions/departments, then  this  practice   must  stop  forthwith and  duty   rosters  for  resident doctors  are  prepared in a way  that  they  are  put  on clinical duties  not  exceeding  12 hours in a shift in a day.

Exceptionally, in cases of working/clinical needs for  more  than 12 hours  of continuous shift duty, only the Director/Medical Superintendent of the hospital  will have  the  power  to  approve assigning clinical  duty  shift  beyond  12  hours  but  not exceeding 17 hours. However, for   all   such   cases, MS/Director of hospitals/ institutions shall inform the Secretary (H&FW) at pshealth@nic.in.

This has approval of the competent authority.
 
(Dr. Sanjay Agrawal)
Addl. Secy. (PGR)/
Director (Hosp Services)
 H&FW Department
To,
  1. All Directors/MSs of Hospital/Institutions in H&FW Department
  2. All Heads of clinical departments of Hospitals/institutions through respective Directors/MSs.
    Copy for information:
    1. Secretary to Min. of Health
    2. All Spl. Secretaries/Addl. Secretary, H&FW Department
    3. PS to Secretary  (H&FW)
Facts about Tuberculosis (TB)
Is there a vaccine for TB?

BCG (Bacille Calmette–Guerin) vaccine is currently the only vaccine available against TB.

Though BCG appears to reduce the risk of serious childhood forms of TB it is not effective in preventing TB in adults and children.
Notify TB patients: IMA to doctors
Urging doctors to take care of tuberculosis patients till they are cured completely, the Indian Medical Association (IMA) today asked them to also notify such patients.

 At a workshop attended by 100 general practitioners, the IMA appealed to all its members to ask themselves the question "I have notified TB patient today, have you?"

 "Not notifying TB patient is not only a public hazard but also a violation of Medical Council of India Act and can lead to suspension of license of a doctor," said Dr K K Aggarwal, Secretary General of IMA.

 Dr Aggarwal further said that it is not only important to notify TB patients, but equally important to follow the patient till he or she is cured.

 "Most symptoms will disappear within a few weeks of treatment and there is a tendency for patients to stop treatment. Incomplete treatment can end up being drug resistance case which may not only be lethal to the patient, but also be a health hazard to the community," he said.

 IMA lauded the initiative by Bollywood actor Amitabh Bachchan who openly said that he had suffered from abdominal TB in the past.

 Experts at the workshop said all pregnant ladies and lactating mothers suffering from TB should be given full treatment. Every patient of HIV should be followed for possible development of TB in the future.

IMA also released two slogans: "If an elderly patient develops diabetes – think of TB" and "If a middle aged person develops TB - think of diabetes".
IMA launches new campaign against TB
The Indian Medical Association (IMA) has launched an aggressive campaign to identify TB patients and put them on treatment immediately. The Association – the largest non–government organisation of doctors in India – has come out with “Have I notified a TB patient today? Do it today” and on Monday it held its first workshop which was attended by 100 general practitioners.

“We have also appealed to all our members to ask themselves this important question about TB notification at the end of each working day,” said IMA secretary general Dr. K. K. Aggarwal.

 Not notifying TB patient is not only a public hazard but also a violation of MCI Act and can lead to suspension of licence of a doctor.

 Dr. Aggarwal further said it is not only important to notify TB patients, but equally important to follow the patient till he/she is cured.

 The Association has maintained that most symptoms will disappear within a few weeks of treatment and there is a tendency for patients to stop treatment. Incomplete treatment can end up in drug resistance, which may not only be lethal to the patient, but also a health hazard to the community.

 “We appreciate actor Amitabh Bachchan openly speaking about the fact that he had suffered from abdominal TB in the past. All pregnant ladies and lactating mothers suffering from TB should be given full treatment.  Every patient of HIV should be followed for possible development of TB in future,” noted a release issued by the Association.

 IMA also trained a group of Municipal Corporation teachers about respiratory hygiene and cough etiquettes. “We sensitised over 100 MCD teachers to help prevent the spread of swine flu and TB. Both swine flu and TB have cough but if the cough lasts for more than two weeks, TB should be ruled out,” noted the IMA release.
Genital TB leading to infertility among 25-30% women in India
NEW DELHI: Female genital tuberculosis is fast emerging as a major health issue that affects fertility levels in women. Doctors say tuberculosis is a major cause of infection leading to infertility among 25–30% of women in India.

 "There is an increasing trend of genital tuberculosis among women. The infection can attack the ovaries, uterus and tubes leading to infertility problems among women," says Dr Kaberi Banerjee, a leading IVF and infertility specialist.

 According to Dr Banerjee, the disease is also becoming more evident among men causing infertility. "Even among men, who are responsible in 50% of infertility cases, tuberculosis is a major reason for infection," she said.

 Doctors say such tuberculosis infection is often serious as they can damage the complete tube making it difficult for females to conceive. It can lead to hydrosalpingitis. "If not detected at an early stage, it can lead to severe complications. In some cases, women are never able to conceive after they develop hydrosalpingitis," says Dr Banerjee.

 Among 30% of women with any kind of tuberculosis 5–10% suffer hydrosalpingitis, where water enters the tube.

Detection and treatment of tuberculosis remains a challenge even as it is one of the oldest diseases impacting Southeast Asian countries including India and Bangladesh, where the bacteria is very rampant. While secondary or pulmonary tuberculosis, which first attacks lungs and then shift to other parts of the body, is comparatively easier to detect, primary infection of the disease hitting genital organs often at an advanced stage is not identified at all.

"Diagnosis and treatment of tuberculosis is a major challenge. There is very little known and even less available. Fertility chances are poorer in women suffering from tuberculosis if they are not treated appropriately and adequately," says Dr Neerja Bhatla, professor in department of obstetrics & gynaecology at All India Institute of Medical Sciences (AIIMS).

 Low detection rate for the disease among women as well as men is attributed to several reasons. While dearth of infrastructure, policy and tools to diagnose the disease is a major hurdle, social stigma attached to the disease is also a significant reason of concern.

 "Over 10 lakh cases are not notified at all. Most symptoms will disappear within a few weeks of treatment and there is a tendency for patients to stop treatment. Incomplete treatment can end up becoming a drug resistant case which may not only be lethal to the patient, but also be a health hazard to the community," says Dr K K Aggarwal, secretary general, Indian Medical Association.

According to health ministry data, 170 new cases of tuberculosis per lakh population are reported every year. Though it has come down over the past decade, it is still significant with a prevalence of 211 cases per lakh people. Moreover, in the absence of a proper tracking mechanism, a lot of unreported cases may spread the bacteria.
10,000 new TB cases diagnosed in Tamil Nadu
CHENNAI, March 23, 2015: As many as 10,000 persons were diagnosed with tuberculosis (TB) by private practitioners in the last one year in Tamil Nadu. The largest concentration of such persons was in northern and central regions of the State.

Though private practitioners must notify a case once diagnosed, often they are hindered by the tedious process. The private sector treats around 20 to 25 per cent of the population. A fifth of the patients diagnosed go ‘missing’ as they are not accounted for.

“Across the country, over one lakh cases have been identified this year. We hope that in another five years all the missing cases would be accounted for,” says M. Balasubramaniam, national working group member of the Indian Medical Association.

The largest number of patients identified in Tamil Nadu was in the Coimbatore-Nagapattinam belt and the northern regions. “Though in the southern districts too more people seek treatment in primary hospitals, it all depends on the consultant’s enthusiasm,” he adds.

The association is trying to get around the mindset of pulmonologists. Although the government has laid down the thrice-weekly Directly Observed Treatment Short-Course (DOTS) treatment, which the village health nurse can monitor, private practitioners prefer the daily regime.

“Once the patient is diagnosed through sputum examination, we notify the district TB officer and free medicines are given to the peripheral institute, from where the patient can pick them up free. Many pulmonologists, however, give the patient the option of the daily regime and patients choose to buy the medicines from private sector despite the higher cost,” he adds.

Last year, the association suggested the Kerala model under which State TB officer buys medicines in bulk and provides them to the peripheral institution.
Inspirational Story
Trust Your Relationship

 When you've seen a couple fighting or having a pity argument, what is the first thing that comes in your mind?

 Probably you think that you will never allow arguments to set in your relationship (especially when you get married), or will never think to start one, but arguments seem to come naturally.

 You argue about the brand of coffee, or what to eat at lunch, who will do the dishes, etc. Sometimes, more than that, but regardless of your reasons for the argument (or fight), patching up a troubled relationship and having a solution is very important.

 Second to God, our partners are a believer's most valuable asset. Companions provide a listening ear for our troubles, support for our dreams, and a safety net when we fall. They give us love, even when we are unlovable. They are and must be our friends.

 Inevitably, though, sometimes we go through troubled periods and a solution should be sought through the following steps:

 1. Address the situation. Acknowledge to your partner that something is amiss and needs to be fixed.

 2. Determine the problem. Together, discuss where the relationship veered off course and what wrongs may have been spoken or committed. Be honest and let your honesty be in its proper place. Remember, you are talking to your partner, another half of yourself.

 3. Apologize. As believers we accept responsibility for our actions and seek forgiveness.

 4. Refuse to blame. In addition, we must avoid defending ourselves. There could be a temptation to argue over who did what; however, the goal is not proving who is right but saving the relationship.

 5. Begin repairs. Ask, "What can I do to rebuild our closeness?" The key here is to do willingly whatever is requested.

 6. Commit to rebuilding. Immediately start investing your time, energy, and love in restoring the relationship.

 In order to have the blessing of a good relationship, with a partner who accepts and loves us, we must be willing to pay the high price of patching things up. Walking away might seem easier, but in the long run, we would lose a valuable treasure. God bless you both.
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IMA Humor
Visiting a barber

A man enters a barber shop for a shave. While the barber is foaming him up, he mentions the problems he has getting a close shave around the cheeks.

"I have just the thing," says the barber taking a small wooden ball from a nearby drawer. "Just place this between your cheek and gum."

The client places the ball in his mouth and the barber proceeds with the closest shave the man has ever experienced. After a few strokes the client asks in garbled speech.

"And what if I swallow it?"

"No problem," says the barber. "Just bring it back tomorrow like everyone else does."
Press Release of the Day
IMA distributes kitchen plants to create TB Awareness

On the occasion of World TB Day, IMA in association with Heart Care Foundation of India distributed over 500 kitchen plants with TB Health Message: “TB Anywhere – TB Everywhere”.

Giving details, Padma Shri Awardee, Prof Dr A Marthanda Pillai, National President IMA and Padma Shri Awardee, Dr K K Aggarwal, Hony. Secretary General, IMA and President, Heart Care Foundation of India said that one million TB cases in India are missing as either they do not get treatment or they do not get notified during treatment. IMA will notify 50% of them in the next year.

Dr Aggarwal further said that irrespective of specialty of doctors in the country, all should join the TB movement.

Multidrug resistance TB is not in the interest of the country.  If the spread of multidrug resistance TB is not stopped, it can take the shape of an epidemic and will not spare people from any walk of life. 

It is a misnomer that TB is a disease of the poor. Dr Aggarwal said that “forget the rich class, even 5% of health care professionals develop TB over their lifetime".

All workers (drivers, security men, attendants and maids etc.) should be screened for TB before they are inducted in the job.

It is also a myth that TB is a disease of adults.  A large number of children today are being diagnosed with TB.

In the last one year IMA has sensitized over one lakh persons trained 16000 GPs and notified over one lakh TB patients.

In the last one week, IMA sensitized over 100 nursing teachers, over 300 school principals, over 100 general practitioners, over 1000 medical college students, over 250 college students and over 500 school children.